Time to Talk: Addiction, mental health ‘inherently linked’

For many, substance abuse is a way of self-medicating

Karin and Terry Schamberger celebrated their 25-year wedding anniversary in August. "I try not to forget that every day he makes a choice to be sober and that it really takes amazing strength to maintain it," Karin said.

Jessica Gibbs

Posted
Thursday, September 6, 2018 11:52 am

John Douglas is the executive director of the Tri-County Health Department.

Courtesy photo

Dennis Ballinger is the director of addiction and forensic services for AllHealth Network.

Courtesy photo

Terry Schamberger of Highlands Ranch is 11 years sober after decades of living as an alcoholic.

Terry Schamberger took his last alcoholic drink on July 1, 2007, about 27 years after he drank his first beer at 13.

Alcohol, he believes, was about to cost him his family.

“I knew my kids were being affected by it. They saw the problem that I had. I think Karin was on the verge of potentially leaving me,” he said of his wife. “I knew that if I wanted to have any kind of life with them I was probably going to have to do something.”

He is 51 now, celebrating 11 years as a sober man.

A longtime Highlands Ranch resident, Schamberger started drinking during a traumatic personal period in his life. As he got older, alcohol became his door to fun, but also helped push down feelings of loss and childhood traumas and calm the emotional storm inside. It would be more than 20 years before he would receive treatment for his depression.

He understands now, he said, how his need to drink was unequivocally intertwined with the state of his mental health. And how both issues needed to be addressed to overcome his addiction.

As sobriety set in, he finally found joy in living.

“It’s almost like really the only life that I had has been the last 11 years,” Schamberger said, “where I’ve really felt life.”

`A double-headed monster’

According to the Robert Wood Johnson Foundation, a national philanthropy supporting health-based research, Douglas County ranked as the healthiest county in Colorado in 2018 for the third consecutive year. High graduation rates, ample opportunities to exercise and a low unemployment rate were cited among key reasons.

And a 2018 report by the Colorado Health Institute, a nonpartisan health research organization, states Douglas County residents boast some of the best rates for good mental health and access to care in the state.

But in Douglas County, where the median household income is $109,292 — the seventh-highest in the nation among counties with a population of 65,000 or more, according to county demographic reports — alcohol abuse, including binge drinking, among adults and youth is a paramount concern, said John Douglas, director of Tri-County Health Department, which provides a range of health services in Douglas, Arapahoe and Adams counties.

People with higher incomes and level of education may be more likely to drink, Douglas said. That’s partially because alcohol can be more expensive than street drugs, but also because “folks with higher incomes are more likely to be able to do things like go out to eat or to do social events — and those events are likely to have alcohol as part of the theme.”

Nationally, 7 percent of adults in 2015 reported heavy alcohol use in the past month and nearly 27 percent of adults said they had engaged in binge drinking in the past month, according to the National Institute on Alcohol Abuse and Alcoholism.

A community-needs assessment from the Tri-County Health Department reported that between 2012 and 2014 nearly 16 percent of all adults in Douglas County and nearly 20 percent of adults with children under 18 reported binge drinking. About 1 in 5 adults binge drink in Colorado, according to the Colorado Department of Public Health and Environment.

According to the National Institute on Drug Abuse, multiple national surveys indicate about half of individuals who experience a substance use disorder also are dealing with a mental illness, and vice versa. Among secondary effects that arise from alcohol dependency are anxiety, depression and, in extreme cases, suicide.

Mental health and substance abuse are “inherently linked,” said Dennis Ballinger, director of addiction and forensic services for AllHealth Network, a nonprofit that provides behavioral and mental health treatment in Douglas and Arapahoe counties. “It’s kind of a double-headed monster that we’re trying to deal with.”

In Douglas County, data on how many people are seeking treatment for mental health conditions, substance abuse disorders, or both, is largely unclear because there is no comprehensive tracking system. People seek treatment through private care, Medicaid, in-state and out-of-state rehabilitation facilities.

Dan Makelky, director of Douglas County Department of Human Services, said his department gets a glimpse of the issue’s scope at the local level through the number of child welfare cases they oversee with links to mental health or substance abuse.

“Oftentimes, that is something that we find as an underlying factor,” Makelky said.

Ruby Richards, a child welfare administrator with the county, said of the department’s on-going cases, which require repeated visits and oversight from the county, 90 percent are linked to mental health, substance abuse or both.

Other risk factors such as genetics, stress or trauma, also can lead to a person developing a substance abuse problem or mental health illness, rather than one leading to the other, according to the National Institute on Drug Abuse.

`It just kind of numbed me’

For Schamberger, the path to addiction started with emotional trauma.

On a day in June, he sat at his kitchen table, thinking back through the years. He grew contemplative, took a deep breath, a sip of water. He stared into space, searching for the right words. The story is still difficult to tell.

He grew up in Colorado Springs with his mother, two older brothers, sister and a stepfather, who he said was cruel and demeaning.

When he was 11, his older sister died in a car accident as the passenger of a driver who was under the influence of drugs and alcohol. By 13, his mother had divorced and remarried “a good man” who Schamberger looked to as a father figure, but who died unexpectedly of cardiac arrest.

In grieving their deaths, Schamberger found himself isolated.

“My mom for the most part, she pretty much checked out,” he said. “And I don’t fault her at all because she had just lost her only daughter, and so she was struggling just to make it.”

The whirlwind of tragedy left Schamberger in emotional pain. Then he found his brother’s stash of beer in the garage and drank a 16-ounce can of Schlitz.

That first time, he became so sick he couldn’t do his paper route. But he also discovered a way to self-medicate.

“It just kind of numbed me,” he said. “I began finding that I could get away from the pain when I used it.”

Throughout middle school, he and friends “easily obtained alcohol” through contacts at liquor or convenience stores. In high school, the partying exploded. He and his friends would steal liquor from delivery trucks under the guise it was for a party. But for Schamberger addiction had set in, and the parties were about drinking.

“I had to have it,” he said.

`Addiction is a family disease’

Drug use and addiction can begin at any age, but it typically begins in adolescence, which is also when the first signs of mental illness commonly appear, according to the National Institute on Drug Abuse.

"If I was to picture someone who's a drug addict, in your mind, most people picture the homeless person on the street who's been drinking for 30 years," Ballinger said. "I picture the 13-year-old who's started to drink at 13 because there are problems at home, or things aren't going well for them."

Countless reasons can lead teens to try substances, he said, naming conflicts with parents and struggling in school as two examples. When mental health and substance abuse go untreated, addiction can form and life-long behavioral problems arise.

"The majority of addiction is set in," Ballinger said, "before the age of 21."

Looking back, Schamberger believes that was true for him: Addiction had formed by his teen years; he also was struggling with depression.

After high school, his alcoholism progressed to new levels.

He studied computer science, ultimately earning a master’s degree, and landed a job in downtown Denver working as a project manager. Three blocks from his office was a liquor store where he’d stop in mornings before work.

“I was on a first-name basis with the owners,” Schamberger said.

He’d drink any time of day — in the mornings and at lunch. After work, he’d finish six to eight beers a night. In the later years, he drank more and more hard liquor.

“I was fortunate to be a pretty good working alcoholic,” he said. “But I was tanking pretty quick at the latter half of my 30s.”

His wife, Karin, didn’t understand the extent of his addiction at first.

“Looking back, I believe I was in denial,” she said, explaining they did argue on occasion about his drinking but she didn’t know where to draw the line. “I didn’t know what was normal drinking — I grew up in a family that didn’t drink.”

They married when she was 22 and he was 26. She found it odd he’d insist on planning events around alcohol, and she began to notice his reliance on drinking.

But for a time, he could manage it, she said, until eventually, “it was starting to manage him.”

By the time Schamberger turned 40, Karin and their two sons were witnessing the drinking and the Jekyll-and-Hyde change in his personality: When Schamberger got drunk, he became unpredictable, until eventually he was simply mean, he said.

“Addiction is a family disease. It affects everybody in the family,” Karin said. “Everybody gets kind of sick.”

Schamberger believes he was on a path to death: If he didn’t eventually drink himself to death, he suspected one day the alcohol would no longer mask his feelings, and he’d die by suicide.

Treatment is two-fold

The key to treatment should be addressing mental health and substance abuse issues simultaneously, said Dianna Sandoval, executive clinical director of the private Sandstone Care rehab facility in Denver.

But some rehab programs only treat one or the other or try to address one condition at a time.

“It’s like saying to someone, you have an infection in your arm and an infection in your leg, but I only work on legs,” Sandoval said.

In recent years, the industry has seen a push to ensure clinicians have dual accreditation in mental health and substance use areas and that programs are prepared to treat both conditions.

An integrated approach, Sandoval said, “is everything.”

Ballinger agreed.

“Everybody that provides care is also a mental health clinician,” he said of AllHealth’s substance use programs. “What we’re really looking at is what is typically called co-occurring disorders.”

The path to sobriety and a healthy mental state isn’t easy, said Lisa Fiola, a program manager at Mental Health Center of Denver, a nonprofit organization that provides mental health and therapy programs to children, adults and families.

“It’s not a linear process, but if they’re patient and they keep working at it, they can get help,” she said. “They can recover. They can get better. They can have a better life. Hope is really that foundation.”

When God steps in

Karin feels like she’s been married to three separate people — the version Terry was when they met, the active alcoholic and, now, the sober man.

“Hands down, I will take the one in sobriety,” she said. “It’s like all the goodness of him was in there, but it is becoming more and more awakened through the healing of sobriety.”

Schamberger drank until the night before he voluntarily entered a four-day detox program at the Medical Center of Aurora in 2007. Such programs provide medical supervision for people withdrawing from alcohol. The decision came as his marriage and relationships with his children were unraveling.

Schamberger said he vaguely recalls the experience because he was sedated on medications. Leaving detox, he didn’t feel different, or that he was on the road to recovery. In fact, he said, he felt like he needed a drink.

His first day returning to work out of detox, Schamberger left the office — and without thinking — slipped back into his years-long routine by walking to the nearby liquor store.

When he reached for the store’s door, it didn’t open.

Schamberger peered inside and saw only empty shelves. In the time he had been in detox, the liquor store had closed for business.

He took it as a sign from God.

“I’m a firm believer,” he said, “and I believe that God stepped in for me on this.”

Schamberger entered and successfully managed a 12-month outpatient program through Valley Hope of Denver, a nonprofit offering outpatient services in Centennial. He began about one week after detox and received mental health counseling once a week. His substance abuse counseling lasted for three hours, four nights a week.

The first four years after entering treatment were the most grueling.

“I felt like a third-degree burn victim,” he said.

Confronting the grief of his early years, acknowledging the hurt he had caused his wife and children, was painful — and he could no longer use alcohol to hide from his feelings.

During those early years of sobriety, he consistently attended Alcoholics Anonymous meetings. Being near “other admitted broken people, not feeling like you are lower than someone else,” was crucial in the beginning, he said.

After his outpatient program, he also saw a psychologist and took medication for a year to treat depression. As his recovery progressed, Schamberger felt he needed to surround himself with people who were not addicts, and he stepped away from AA.

“I appreciate so, so much his sobriety,” Karin said. “I try not to forget that every day he makes a choice to be sober and that it really takes amazing strength to maintain it. Gone is the chaos of living with an active alcoholic, the living on pins and needles.”

On Aug. 14, the couple celebrated 25 years of marriage.

Being alive, Schamberger said, being in his children’s lives and becoming a better husband has brought him happiness.

“I am so very thankful to my wife. I really didn’t deserve her in the first place, and most certainly didn’t deserve her during my substance abuse,” he said. “I can only say thank you to her through my battles with not giving up. I am honored to have her, and hope I can give her a better next 25 years.”

Two people were killed after a woman driving a stolen car crashed into their vehicle at the intersection of Santa Fe Drive and Mineral Avenue in Littleton in the early hours of Feb. 6, according to the Douglas County Sheriff's Office.